A Retrospective Study of 75 Cases of Splenic Abscess

Abstract

Splenic abscess is an uncommon and lifethreatening condition. Due to its nonspecific clinical picture, it remains a diagnostic challenge. Multiple radiological modalities are used for the diagnosis. In this retrospective study we analyzed 75 patients treated between 1999 and 2009. The patients were divided into three groups depending on the treatment received. Group I (n=14) consisted of patients treated with only antibiotics, Group II (n=19) patients were treated with percutaneous drainage and Group III (n=42) with splenectomy. We tried to establish epidemiologic and clinical features and therapeutic options in splenic abscess. Our study suggests that percutaneous drainage is a safe and effective alternative to surgery especially in unilocular or bilocular abscesses thus allowing preservation of the spleen. It should be considered as the first line of treatment although splenectomy remains the final definitive procedure if percutaneous drainage fails.

Uncommon cause of pneumoperitoneum

“…Three etiological causes of splenic abscesses have been proposed by Kuttner: trauma with secondary infection; per continuitatem; and haematogenous spread [12] . Development by continuitatem has been described in perforated gastric ulcer, perinephric abscess, septic abortion, appendicitis with perforation and in case of concomitant colon carcinoma [1,3,13,14] . Colon carcinoma are also important precursors in the small number of cases in which metastasis of the spleen were secondary infected [15] .…”

“…Splenic abscess is a rare condition with a reported frequency in autopsy series between 0.1% to 0.7% [1][2][3] . Presenting symptoms include upper abdominal pain, recurrent or persistent fever, nausea and vomiting, splenomegaly, leukocytosis and left lower chest abnormalities [4,5] .…”

“…Diagnosis of a splenic abscess is confirmed on ultrasound or computed tomography (CT)-imaging of the abdomen. Splenectomy has been the gold standard treatment for splenic abscess, however more recent percutaneous drainage is also suggested to be safe and effective [1,6,7] . While gas formation in splenic abscess has been described, few have reported pneumoperitoneum as presenting symptom of a ruptured splenic abscess [8][9][10][11] .…”

Splenic Abscess with Bleeding in a Female Patient Following Coronary Artery Bypass Grafting and Cholecystectomy – A Case Report and Literature Review

“…Splenic abscess is a rare, but potentially life-threatening condition, with a reported frequency of 0.1-0.7% (1). Splenic abscess is observed in the course of many clinical conditions, most commonly as a complication of splenic trauma or blood-borne or direct bacterial infections (1).…”

“…Splenic abscess is observed in the course of many clinical conditions, most commonly as a complication of splenic trauma or blood-borne or direct bacterial infections (1). In conscious patients clinical manifestation involves pain in the left-upper abdominal quadrant, fever, nausea and vomiting.…”